Indiana State Department of Health

About... Botulism

What is botulism?

Botulism (boch-uh-liz-uhm) is a very serious disease caused by a nerve toxin (poison) produced by the Clostridium botulinum bacterium, which lives in the soil and grows best with very little oxygen. These bacteria form spores, which allow them to survive harsh environments. The toxin can cause muscle paralysis, which can result in death if the breathing muscles become paralyzed. Botulism is considered a medical emergency. On average, one case of botulism is reported in Indiana every two years.

How is botulism spread?

Botulism is not spread from person to person. There are three types of botulism:

Intestinal botulism (formerly infant botulism) results from eating certain foods, e.g., honey or natural syrups, that contain spores of botulism bacteria. These spores grow in the body and produce toxin in babies and people with gastrointestinal disorders.

Muscle paralysis that begins in the upper body and progresses downward (“descending paralysis”)

Muscle paralysis involves both sides of the body at the same time, starting at the head and moving towards the feet. These symptoms, which are the result of the bacterial toxin paralyzing the muscles of the body, worsen over a short period of time. Symptoms of botulism typically begin within 12-36 hours (range of 6 hours to 10 days) after consuming contaminated food or after a wound has become infected with the bacteria. Babies with botulism appear tired, do not feed well, are constipated, and have a weak cry and limp muscles.

Are there complications from botulism?

People can die from botulism poisoning because of breathing failure and infection in the lungs. Death occurs in 5-10% of cases. Someone with severe botulism may need assistance from a breathing machine and medical care for several months. The paralysis slowly improves after several weeks. Those who survive botulism poisoning may experience tiredness and shortness of breath for years.

How do I know if I have botulism?

A person with symptoms involving eyesight or speech should see a health care provider immediately. Other illnesses may produce symptoms that resemble botulism. The health care provider may order tests to rule out other diseases and may collect a stool or blood sample. It is important to note that laboratory tests will not always come back positive for a person with botulism.

How is botulism treated?

If discovered early, botulism caused by contaminated food or an infected wound can be treated with an antitoxin. While the antitoxin keeps the illness from becoming worse, it does not speed recovery. Antitoxin is rarely used to treat babies with botulism. Because the antitoxin can cause severe allergic reactions in some patients, the health care provider must rule out other possibilities for the illness before giving antitoxin.

Is botulism a reportable disease?

Yes. Health care providers or laboratories must immediately report any suspect cases of botulism to the Indiana State Department of Health (ISDH). The local health department will contact all suspect botulism cases so a possible exposure can be determined to help prevent others from becoming ill.